1. Performances, feasibility and acceptability of nasopharyngeal swab, saliva and oral-self sampling swab for the detection of severe acute respiratory syndrome coronavirus 2
- Author
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Audrey Mérens, Christophe Renard, Anne Margaux Legland, Julie Plantamura, Olivier Bylicki, Marie Pierre Otto, Eric Garnotel, Aurore Bousquet, Frédéric Janvier, Hervé Delacour, Elodie Valero, Christine Bigaillon, Vincent Foissaud, P. Vest, Catherine Verret, Solenne Martin, Hélène Astier, Laboratoire de Microbiologie [Hôpital d'Instruction des Armées Bégin, Saint-Mandé] (Service de Santé des Armées), Hôpital d'Instruction des Armées Bégin [Saint-Mandé, France], Hopital d'instruction des armées Sainte-Anne [Toulon] (HIA), Service de Santé des Armées, École du Val de Grâce (EVDG), French Military Health Service Academy, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Hôpital d'Instruction des Armées Laveran, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Laboratoire de biologie médicale, and Service de Santé des Armées-Hôpital d'instruction des Armées Percy
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Saliva ,Coronavirus disease 2019 (COVID-19) ,Hospitalized patients ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,030106 microbiology ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Internal medicine ,Medicine ,Sampling (medicine) ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,business.industry ,General Medicine ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,Infectious Diseases ,Multicenter study ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,business ,Self sampling - Abstract
Molecular diagnosis on nasopharyngeal swabs (NPS) is the current standard for COVID-19 diagnosis, but saliva may be an alternative specimen to facilitate access to diagnosis. We compared analytic performances, feasibility and acceptability of NPS, saliva, and oral-self sampling swab for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A prospective, multicenter study was conducted in military hospitals in France among adult outpatients attending COVID-19 diagnosis centers or hospitalized patients. For each patient, all samples were obtained and analyzed simultaneously with RT-PCR or transcription-mediated amplification method. Clinical signs, feasibility, and acceptability for each type of sample were collected. A total of 1220 patients were included, corresponding to 1205 NPS and saliva and 771 OS. Compared to NPS, the sensitivity, specificity, and kappa coefficient for tests performed on saliva were 87.8% (95% CI 83.3-92.3), 97.1% (95% CI 96.1-98.1), and 0.84 (95% CI 0.80-0.88). Analytical performances were better in symptomatic patients. Ct values were significantly lower in NPS than saliva. For OS, sensitivity was estimated to be 61.1% (95% CI 52.7-69.4) and Kappa coefficient to be 0.69 (95% CI 0.62-0.76). OS was the technique preferred by the patients (44.3%) before saliva (42.4%) and NPS (13.4%). Instructions were perceived as simple by patients (> 90%) for saliva and OS. Finally, the painful nature was estimated to be 0.9 for OS, on a scale from 0 to 10, and to be 5.3 for NPS. Performances of OS are not sufficient. Saliva is an acceptable alternative to NPS for symptomatic patient but the process required additional steps to fluidize the sample.
- Published
- 2021
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